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News Article
Suspected Covid outbreaks in UK hospitals double in a week
Patient Safety Learning posted a news article in News
Suspected Covid outbreaks in hospitals across the UK have doubled in a week, official figures reveal – though the number of people admitted to wards with the virus is falling across much of England. As parts of the NHS battle to cope with a surge in infected staff and patients, UK Health Security Agency (UKHSA) data show there were 66 acute respiratory infection incidents in UK hospitals in the seven days to 16 December. Coronavirus was confirmed in most of these incidents, according to a UKHSA document reviewed, by the Guardian. It represents a doubling in outbreaks compared with the previous week (33) and is the highest total recorded since the third week of January 2020. Most of the outbreaks happened in London, with 28 recorded in the last week, almost half of all those in England (62). Nine were recorded in West Midlands hospitals, six in the east of England and five in the east Midlands. Hospitals are scrambling to try to stop the highly transmissible Omicron variant spreading between patients and staff, NHS leaders said, while trying to cope with more pressure than last year. Saffron Cordery, deputy chief executive of NHS Providers, said: “The safety of staff and patients is a key priority of trust leaders, and trusts are doing everything they can to keep nosocomial [hospital-acquired] infections to a minimum, including following stringent infection control measures and social distancing rules.” Read full story Source: The Guardian, 22 December 2021 -
News Article
NHS hospitals are not ‘scaremongering’ about a winter Covid wave
Patient Safety Learning posted a news article in News
David Oliver, NHS consultant physician and a columnist for the BMJ makes a plea on behalf of his colleagues as they face a surge of admissions due to the spread of the omicron variant of COVID-19 this Christmas. "Pandemic health protection measures are not all about you and your own personal risk or appetite for it, your own ‘natural immunity’ or fitness, your own liberty or freedom. They are about protecting everyone else. It might be your own parent, grandparent or sibling that dies from COVID-19 or from lack of access to overwhelmed services. It might be your neighbour’s or someone in another town or from another social class or ethnic group, This isn’t a game and we need to take it seriously and stop posturing and point-scoring, before, once again, we have left it too late to act" Read full story Source: Byline Times, 21 December 2021 -
News ArticleMore than 167,000 children are believed to have lost parents or caregivers to Covid during the pandemic – roughly one in every 450 young people in the US under age 18. The count updates the October estimate that 140,000 minors had lost caregiving adults to the virus, and is four times more than a springtime tally that found nearly 40,000 children had experienced such loss. In a report titled Hidden Pain, researchers from the COVID Collaborative and Social Policy Analytics published the new total, which they derived by combining coronavirus death numbers with household-level data from the 2019 American Community Survey. The death toll further underscores the daunting task facing schools as they seek to help students recover not just academically, but also emotionally, from a pandemic that has already stretched 22 months and claimed more than 800,000 American lives. It’s an issue of such elevated concern that Surgeon General Vivek Murthy, on 7 December, used a rare public address to warn Americans of the pandemic’s “devastating” effects on youth mental health. An accompanying 53-page report calls out the particular difficulties experienced by young people who have lost parents or caregivers to the virus. Bereaved children have higher rates of depression and post-traumatic stress disorder than those who have not lost parents, according to a 2018 study that followed grieving children for multiple years. They are more than twice as likely to show impairments in functioning at school and at home, even seven years later, meaning these children need both immediate and long-term counseling and support to deal with such a traumatic loss. “For these children, their whole sky has fallen, and supporting them through this trauma must be a top priority.” Read full story Source: The Guardian, 22 December 2021
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Content Article
We catch up with a regular contributor to the hub, theatre nurse Kathy Nabbie, to discuss how she is continuing to ensure patient's are kept safe in theatre, the challenges of COVID-19 and what else we can do to improve safety in the theatre. Kathy was a theatre sister for breast oncoplastic surgery and a practice development lead in a London private hospital group up until August 2017. She now works as a locum theatre bank scrub nurse practitioner and once a week as a non-medical surgical first assistant. She also works for an insourcing company on weekends around the country to help with the backlog of NHS patients who need surgery or treatment in clinics. -
Content ArticleA post on Doctors in Unite website argue that COVID-19 guidelines are fundamentally flawed and not fit for purpose, putting health care workers and patients at serious risk. IPC authorities are increasingly isolated in their view that COVID-19 is spread by droplets and not through the air, a position which is directly contradicted now by official government policy. This article takes a more detailed look at the issues, which demonstrates how unscientific, out of touch and indeed hazardous the guidelines are for health workers and patients.
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News Article
Covid: Vulnerable NHS patients to be offered new drug
Patient Safety Learning posted a news article in News
A new Covid drug designed to reduce the risk of vulnerable patients needing hospital treatment will be available on the NHS from today. Sotrovimab is a monoclonal antibody given as a transfusion to transplant recipients, cancer patients and other high-risk groups. If given quickly after symptoms develop it is should help prevent people from falling seriously ill with the disease. Initial tests suggest it should still work against the Omicron variant. "These new drugs have an important role to play," said Prof Steven Powis, the national medical director of NHS England. "If you test positive and are at high risk then we will be contacting you, and, if eligible, you will be able to get access to these new treatments." Around 1.3 million of the highest risk NHS patients are eligible to receive Sotrovimab, along with other new Covid treatments as they become available. The drug is most effective if taken in the first five days after infection and is likely to be given in clinics or to outpatients in hospital. It has been approved for use in vulnerable groups - such as those with cancer, diabetes or heart disease. Read full story Source: BBC News, 20 December 2021 -
News Article
People hospitalised with COVID-19 are likely to face a limited recovery
Patient Safety Learning posted a news article in News
People who were hospitalised with COVID-19 and continued to experience symptoms at five months show limited further recovery one year after hospital discharge, a key finding of the Post-hospitalisation COVID-19 study (PHOSP-COVID) has revealed. The NIHR/UKRI-funded study, led by the NIHR Leicester Biomedical Research Centre, also confirmed that people who were less likely to make a full recovery from COVID-19 were female, obese, and required invasive mechanical ventilation (IMV) to support their breathing during their hospital stay. The study found that one year after hospital discharge, less than three in ten patients reported they felt fully recovered, largely unchanged from at five months. The most common ongoing symptoms were fatigue, muscle pain, physically slowing down, poor sleep and breathlessness. Participants felt their health-related quality of life remained substantially worse one year after hospital discharge, compared to pre-COVID. This suggests the physical and mental health impairments reported in the study are unlikely to be pre-existing conditions. Professor Chris Brightling said: “The PHOSP-COVID study is further evidence of the UK’s ability to combine expertise across both disease area and geography to rapidly gather data to help us understand the longer term implications of Long-COVID in hospitalised patients with persistent symptoms. Our findings show that people who were hospitalised and went on to develop Long-COVID are not getting substantially better a year after they were discharged from hospital. Many patients in our study had not fully recovered at five months and most of these reported little positive change in their health condition at one year. “When you consider that over half a million people in the UK have been admitted to hospital as a result of COVID-19, we are talking about a sizeable population at risk of persistent ill-health and reduced quality of life.” Read full story Source: National Institute for Health Research, 16 November 2021 -
News ArticleThe spread of the Omicron variant, which is racing through the population at a staggering speed, has brought renewed focus to the value and reliability of the at-home lateral flow test (LFT). These rapid testing devices were initially viewed with caution by some scientists, who were concerned that the LFTs simply weren’t effective enough in detecting infections. But as more data has accumulated over the past year, the consensus around the devices has shifted and become far more positive. Research from University College London, published in October, suggested that LFTs are likely to be more than 80 per cent effective at detecting Covid, and up to 90 per cent effective for those who are most infectious. However, the emergence of Omicron has changed the conversation. Its rapid acceleration throughout the UK, with more than a million infections expected by next week, has placed the country’s key testing routes – both at-home (LFT) and lab-based (PCR) – under immense strain. “Testing capacity will almost certainly fail to keep up with Omicron,” said Dr Jeffrey Barrett, director of the Covid-19 Genomics Initiative at the Wellcome Sanger Institute. “Even with best efforts we can scale supply linearly, but demand will grow exponentially.” Experts have called on the government to temporarily drop the reliance on PCR lab testing, which typically takes 24 hours or more to return a result but is seen as more reliable, in favour of the lateral flow devices. These can be taken from the comfort of your own home and give a result in a matter of minutes. “LFT will be good enough, especially on people showing symptoms,” said Alan McNally, a professor of microbial evolutionary genomics at Birmingham University. Read full story Source: The Independent, 17 December 2021
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News Article
Many Covid hospital patients do not feel fully recovered year later
Patient Safety Learning posted a news article in News
Fewer than one in three patients who have ongoing Covid symptoms after being hospitalised with the disease say they feel fully recovered a year later, according to a study that offers new insights into potential treatments. As the pandemic has unfolded, a growing body of research has revealed that Covid not only causes health problems in the short-term, but also has long-term effects. Now a study has revealed many of those who had ongoing symptoms after hospitalisation are showing little improvement, with their condition similar at about 12 months after discharge to seven months earlier. “Only one in three participants felt fully recovered at one year,” said Dr Rachel Evans, one of the co-leads of the post-hospitalisation Covid-19 study – or Phos-Covid – which is led by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, although the team says missing data means the figure could be as low as 2 in 10 or as high as 6 in 10. The research – which has yet to be peer-reviewed – reveals how the team collected both self-reported and objective measures of health, such as physical performance and organ function, among 2,320 adults about five months after they were discharged from hospital after having had Covid. They then looked at similar measures for 924 participants at about one year after discharge, 807 of whom had attended the previous follow-up. Between five months and one year after discharge, the proportion of participants reporting feeling recovered remained very similar – at just under 30% at 12 months – as did the prevalence of symptoms including breathlessness, fatigue and pain. Little or no improvement was seen for areas including organ function, physical function and cognitive impairment – or “brain fog” – with about one in 10 participants having a significant degree of the latter 12 months after discharge. “Unfortunately, we weren’t seeing improvements at one year from where people were at five months post-discharge,” said Evans. Read full story Source: The Guardian, 16 December 2021 -
Content ArticleThe Chief Medical Officers (CMOs) of the UK and lead Deputy Chief Medical Officers (DCMOs) for vaccines have considered whether, in the light of the very considerable need to speed up vaccination and boosting in response to Omicron variant, the 15-minute wait for some mRNA COVID-19 vaccines should be suspended. Their view, having considered the views of the COVID-19 Vaccine Benefit-Risk Expert Working Group (EWG), NHS planners and others is that with the low rates of anaphylaxis, in the context of the considerable need for people to be boosted or vaccinated, the 15-minute wait after a vaccination with mRNA vaccine will cause more harm than it can avert because it will significantly reduce the number of people who can be vaccinated over a short period of time. The 15-minute wait should therefore be suspended for first, second and homologous or heterologous boost vaccinations with mRNA vaccine given the current situation, with this operationalised in line with the needs in each of the 4 nations.
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News ArticleEveryone over the age of 18 in England has been promised they can book their coronavirus booster appointment by the end of this year. In a televised address on Sunday evening, Prime Minister Boris Johnson promised to deliver up to a million vaccine doses a day to ensure everyone eligible is offered a slot a month earlier than planned. As part of the "Omicron emergency national mission" he asked NHS staff "to make another extraordinary effort" to meet the new target. This will include more vaccine centres and walk-in sites with extended opening hours, "thousands" more volunteers to deliver jabs and help from the military to oversee operations. However, COVID ICU anaesthetist Dr Ed Patrick told Sky News there are already staff shortages "all over" the NHS, including intensive care, with boosters threatening to make them even worse. "It's a massive concern," he said. "You're taking a really scant resource and then you're pushing it elsewhere, which means that other services get cut." Pat Cullen, general secretary of the Royal College of Nursing, said she is worried about the "scale and pace" of the new rollout, as the "same nurses are already facing huge demands under existing unsustainable pressures". While Chris Hopson, chief executive of NHS providers, warned the health service is "already beyond full stretch" and the changes would see more procedures postponed in the coming days. Read full story Source: Sky News, 13 December 2021
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News Article
GPs in dark over plans to drop care warn move could ‘swamp NHS’
Patient Safety Learning posted a news article in News
GPs and hospital leaders have been left hanging over plans to drop “non-urgent” care, and warn there’s no way to safely stem demand without impacting patients health or “swamping” the NHS further. On Monday evening the NHS published guidance for GPs and hospital leaders over expectations to deliver the government’s new deadline for all adults to be offered a booster vaccine by the new year. The guidance comes as reports surfaced on Tuesday that ministers were warned the NHS should expect a “significant” increase in hospitalisations, as modelling showed Omicron cases may reach 200,000 a day. NHS England sent letters to all GP practices and Trust chiefs on Monday evening setting out some plans to support the vaccine drive, which included opening community vaccine clinics 12 hours a day every day of the week. However, the guidance was not clear on what work GPs and trusts could specifically drop to support the drive. Several NHS leaders raised concerns over the “nightmare” of deciding what care can be reduced, in lieu of any detailed guidance from the government or NHS England, with one leader calling for “clear directive”. Read full story Source: The Independent, 14 December 2021 -
News ArticleThe NHS must apply Covid infection prevention and control measures more robustly if it is to avoid a steep rise in infections within healthcare settings, a senior doctor at NHS England has said. The warning came from NHS England national clinical director for antimicrobial resistance and infection prevention and control Mark Wilcox during a webinar for NHS leaders. He said that the effectiveness of the vaccination programme had led “understandably” to the NHS being more relaxed when it came to Covid IPC. However, he warned that “the effectiveness of the vaccines has diminished substantially with respect to two doses” because of the omicron variant, and that “if we carry on with the level of IPC that we have been lulled into then we will see very significant problems with nosocomial infection”. Read full story (paywalled) Source: HSJ, 14 December 2021
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News ArticleCoroners in England are demanding changes in a series of reports highlighting how the struggling healthcare system’s responses to the pressures of the COVID-19 pandemic contributed to patients’ deaths. Coroners are obliged to write a report recommending action in any cases where they believe that this is necessary to prevent future deaths. Reports now emerging suggest that factors in deaths during the pandemic include the move by GPs to telephone consultations, the requirement for vulnerable patients to attend hospital appointments alone, and the lack of safeguards for patients in care homes. The replacement of in-person appointments by telephone consultations reduced GPs’ ability to pinpoint patients’ needs, the coroners said, and the absence of family members from consultations with vulnerable patients meant that clinicians were often unable to get a full picture of their needs. An example is in the Yorkshire and Humber region which saw an increased incidence of children with severe nutritional anaemia in 2020, resulting in two deaths. Maya Zab, who died aged 11 months, was one of the two. Language barriers had caused missed opportunities for primary carers to see Maya, but this was compounded by the pandemic, said Ian Pears, coroner. The “stay at home” message resulted in fewer one-to-one consultations and meant that healthcare professionals were unable to spot signs of her condition, while the limitation of social contact meant that other professionals and friends were unable to report concerns. Read full story Source: BMJ, 8 December 2021
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News ArticleLessons learnt in relation to increasing uptake of the COVID-19 vaccine among ethnic minority groups should now be applied to the booster programme, a government progress report recommends. This includes continuing to use respected local voices to build trust and to help tackle misinformation, the report from the government’s Race Disparity Unit says. Such approaches should also be carried over to the winter flu and childhood immunisation programmes and be applied to the work to tackle longer standing health disparities. In June 2020 the minister for equalities was asked to look at why COVID-19 was having a disproportionate impact on ethnic minority groups and to consider how the government response to this could be improved. This latest report is the final one of four. Taken together the reports identified that the main factors behind the higher risk of COVIDd-19 infection for ethnic minority groups include occupation, living in multigenerational households, and living in densely populated urban areas with poor air quality and high levels of deprivations. Read full story Source: BMJ, 3 December 2021
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Content Article
Post-COVID syndrome symptoms, functional disability, and clinical severity phenotypes in hospitalized and nonhospitalized individuals: A cross-sectional evaluation from a community COVID rehabilitation service (15 November 2021)
Patient Safety Learning posted an article in Data, research and statistics
There is currently limited information on clinical severity phenotypes of symptoms and functional disability in post-coronavirus disease 2019 (COVID) Syndrome (PCS). A370 PCS patients from a dedicated community COVID-19 rehabilitation service was assessed using the COVID-19 Yorkshire Rehabilitation Scale where each symptom or functional difficulty was scored on a 0–10 Likert scale and also compared with before infection. Phenotypes based on symptom severity were extracted to identify any noticeable patterns. The correlation between symptom severity, functional disability, and overall health was explored. -
Content ArticleThis quick guide from Royal College of Occupational Therapists outline the unique role of occupational therapists in supporting adults to manage and recover from Long Covid. They have been written for occupational therapists working in specialist Long Covid services and in other acute, primary, secondary and community settings. The guides will also be useful for service managers and commissioners responsible for planning and delivering specialist Long Covid services, and for parents, carers and families of people affected by Long Covid. See also their guide for children with Long Covid.
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Content ArticleThis is the second of two dynamic reviews of the evidence around people’s experience of the enduring symptoms following a Covid-19 infection. The National Institute for Health Research published their first review of the evidence in October 2020. At the time there was uncertainty about the extent to which there could be lasting effects, and most people assumed a linear progression of a severe acute infection with a long recovery tail. The first review on “Living with Covid-19” was informed by the experience of professionals and the NIHR worked closely with a group of people with lived experience. This review focuses on the published evidence. In addition, it reports findings from a short survey of people living with Covid-19. With over 3,000 responses it provides an insight into the key issues and challenges for people living with Covid-19.
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Content ArticleThe WHO Academy’s mobile learning app was developed specifically for health workers and is designed to enable them to expand their life-saving skills to battle COVID-19. It delivers mobile access to a wealth of COVID-19 knowledge resources developed by WHO, including up-to-the-minute guidance, tools, training, and virtual workshops to support health workers in caring for patients infected by COVID-19 and in protecting themselves as they do their critical work. With content in seven languages – Arabic, Chinese, English, French, Portuguese, Russian and Spanish – the app focuses on providing health workers with critical, evidence-based information and tools to respond to the pandemic.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to recognition of the acutely ill infant and child, recognising the difficulty in distinguishing between simple viral illnesses and life-threatening bacterial infections in very young patients. This Healthcare Safety Investigation Branch investigation reviewed the case of Mohammad, a baby who had become unwell and was taken to an emergency department by ambulance following a call to NHS 111. He arrived at 8.04pm and was considered to have a mild viral illness, subsequently being transferred to a paediatric observational ward, and discharged at 11.45pm with a diagnosis of likely bronchiolitis. At approximately 3.40am his mother contacted the ward as his condition worsened, which resulted in a 999 call. The ambulance crew did not consider that Mohammad was seriously ill so did not conduct a ‘blue light’ emergency transfer to hospital. Mohammad was admitted to the emergency department at approximately 4.40am and suffered a respiratory and then cardiac arrest at 5:28am, with attempts to resuscitate unsuccessful and stopped at 6:10am. Mohammad died of septicaemia caused by meningococcus (serogroup B) bacteria.
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News ArticleHealth experts have expressed fears over the impact tighter Covid restrictions in England could have on cancer patients as alarming new figures reveal that the number taking part in clinical trials plummeted by almost 60% during the pandemic. Almost 40,000 cancer patients in England were “robbed” of the chance to take part in life-saving trials during the first year of the coronavirus crisis, according to a report by the Institute of Cancer Research (ICR), which said COVID-19 had compounded longstanding issues of trial funding, regulation and access. Figures obtained from the National Institute for Health Research by the ICR show that the number of patients recruited on to clinical trials for cancer in England fell to 27,734 in 2020-21, down 59% from an average of 67,057 over the three years previously. The number of patients recruited for trials fell for almost every type of cancer analysed. Health experts said the relentless impact of Covid on the ability of doctors and scientists to run clinical trials was denying many thousands of cancer patients access to the latest treatment options and delaying the development of cutting-edge drugs. Read full story Source: The Guardian, 9 December 2021
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Content ArticleThe Health System Response Monitor (HSRM) has been designed in response to the COVID-19 outbreak to collect and organise up-to-date information on how countries are responding to the crisis. It focuses primarily on the responses of health systems but also captures wider public health initiatives. This is a joint undertaking of the WHO Regional Office for Europe, the European Commission, and the European Observatory on Health Systems and Policies.
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Content ArticleThe launch of Barts Health quality strategy in November 2019 was an important moment for the trust. The 24 page document set out how they would use quality improvement (QI) methodology to become a good and outstanding group of hospitals. Within weeks of the strategy however, the world had changed with COVID-19. How they worked, where they worked and the things they were working on were flipped on their head. Despite this, colleagues across Barts Health have continued to apply the QI skills they had learnt since the WeImprove programme began three years ago. Examples include setting up family liaison hubs for patients in critical care and establishing a network of blood test locations across the boroughs to reduce visits to the hospitals.
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News ArticleThree pharmacy and medication safety organisations are warning clinicians about a reported increase in age-related COVID-19 vaccine mix-ups. The Institute for Safe Medication Practice's National Vaccine Errors Reporting Program said it's seen a "steady stream" of mix-ups involving the Pfizer vaccine intended for kids ages 5-11 and formulations for people 12 and older. ISMP said the reports involved hundreds of children and included young children receiving formulations meant for those 12 and up or vice versa. The safety organisation said some errors were linked to vial or syringe mix-ups. In other situations, healthcare providers gave young children a smaller or diluted dose of the formulation meant for people 12 and up. "Vaccine vials formulated for individuals 12 and up (purple cap) should never be used to prepare doses for the younger age group," the organisation said. Read full story Source: Becker's Hospital Review, 7 December 2021
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News Article
Covid PCR test market a ‘rip-off jungle’, says ex-chair of competition regulator
Patient Safety Learning posted a news article in News
The former chairman of the UK competition regulator has condemned the market for PCR tests for travellers, describing it as a “rip-off jungle”. After the reimposition of the requirement to take the tests on return from abroad, Lord Tyrie accused the government of once again allowing the companies offering PCR tests to manipulate the system by making them available at unrealistic prices. “For this policy to get into a mess once might be seen as a misfortune but for it to resurface again after all the warnings over the summer would have to be described as carelessness,” he told BBC Radio 4’s Today programme. “It was a scandal waiting to happen and it’s now happened and it needs very urgent action.” Last week, the Guardian revealed that a slew of the cheapest deals on PCR tests had been removed from the government website amid concerns travellers were being misled by companies advertising the coronavirus testing service for less than a £1. Private companies offering day two tests for travellers are listed on a government website for consumers to search. However, most of the deals were found to not be suitable for most travellers as they were often offered in only one location, on limited dates and only available to those who could attend in person. “It appears that some of the worst practices – misleading online advertisements, overpricing, unacceptably poor service among them – are still widespread,” said Tyrie, the former head of the Competition and Markets Authority, and the ex-chair of the Treasury select committee. Read full story Source: The Guardian, 8 December 2021
